Surgical results of transcaruncular dacryocystorhinostomy

Abstract

Purpose: The objective of the study is to evaluate the effectiveness of the transcaruncular approach of dacryocystorhinostomy (DCR) in the management of the cases of chronic dacryocystitis. Materials and Methods: A prospective study was conducted on 30 patients presenting in the outpatient department with chronic dacryocystitis at a tertiary eye care center. Intraoperative parameters were observed and noted at the time of surgery. Patients were followed up for a minimum period of 6 weeks and interviewed for subjective improvement of symptoms. Outcome measures were anatomical patency, epiphora, esthetic outcome, and presence of any complications. Results: Thirty patients of chronic dacryocystitis with nasolacrimal duct obstruction comprising 22 females and 8 males with a mean age of 43.8 years were operated by transcaruncular modification of external DCR. The surgical success rate of 90% was achieved after a follow-up period of 6 weeks. Postoperative complications included periorbital edema, mild nasal bleeding, and section leak which resolved by day 7 postoperatively. The procedure was associated with minimal intraoperative complications. One patient (3%) had significant intraoperative bleeding, and two patients (7%) had canalicular injury and both the patients were managed with canalicular intubation. Conclusions: Transcaruncular DCR is a cost-effective and esthetic approach not requiring the use of any endoscope or lasers and provides the benefits of external approach without a skin incision. It is associated with minimal intraoperative and postoperative complications. The surgical success rate of the procedure is comparable to the other conventional methods of DCR.

Keywords

• dacryocystitis
• dacryocystorhinostomy
• nasolacrimal
• syringing
• transcaruncular